We ask everyone to respect and protect community health as the supply chain and our health and retail partners catch up with demand. 142 0 obj <>stream English. Waiving cost-sharing for COVID-19 testing and treatment. Throughout the COVID-19 pandemic, Independence Blue Cross (Independence) has been committed to helping you get the care you need. endstream endobj 461 0 obj <>/ProcSet[/PDF]>>>>stream CareFirst continues to cover the cost of COVID-19 tests administered by a healthcare provider for diagnostic purposes. 1To download the BCBSTX app, text BCBSTXAPP to 33633 or search for BCBSTX in the Apple App Store or Google Play. The Blue Cross Blue Shield companies partner with state and federal agencies, as well as advocacy organizations, to report, investigate and reduce the incidence of healthcare fraud. // ]]>, // /ProcSet[/PDF]>>>>stream The Blue Cross Blue Shield Association is an association of independent, locally operated Blue Cross and Blue Shield companies. These may include your doctors office, a pharmacy or health clinic, or an urgent care center. Your plan covers up to 8 tests every 30 days per covered person. You can use these claim forms to ask us for reimbursement. *Thisprocess applies to members with individual, employer-sponsored or student health plan coverage, as well as Federal Employee Program (FEP) and Federal Employee Health Benefits Program (FEHBP) plan members. A recent announcement from the federal government intends to increase access to COVID-19 testing. In addition, some sites may require you to agree to their terms of use and privacy policy. This page may have documents that cant be read by screen reader software. Blue Shield of California has neither reviewed nor endorsed this information. Some labs may not provide testing without a doctors order. That means members will pay nothing out-of-pocket to take care of their COVID-19-related health needs. BLUE CROSS, BLUE SHIELD and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. All Rights Reserved. You can download the claim form hereor call the number on the back of your member ID card to receive one by mail. endstream endobj 468 0 obj <>/ProcSet[/PDF]>>>>stream Your Blue Cross and Blue Shield of Texas (BCBSTX) health plan gives you access to the care you need during the COVID-19 pandemic. With each claim form, you should include the same receipt. To view this file, you may need to install a PDF reader program. We have a nationwide network of providers that participate with Blue Cross Blue Shield of Michigan. You can find medical and prescription drug claim forms on our Medicare website. Additionally, the federal government now requires commercial health plans to cover the cost of over-the-counter COVID-19 tests for members. Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. If multiple tests are sold in one package, i.e., if one package includes two tests, it counts as two tests and not one test package toward the quantity limit. Commercial members may receive reimbursement for up to eight over-the-counter COVID-19 at-home tests per covered individual in the household per 30-days without a healthcare provider order or clinical assessment. endstream endobj 463 0 obj <>/ProcSet[/PDF]>>>>stream Message and data rates may apply. California Physicians' Service DBA Blue Shield of California 1999-2023. O=>WNW% For the Health of America. Some testing locations may not be in your health plans network, particularly if they arent part of a medical group or facility. Mail your completed claim form with a copy of your receipt(s) to: Blue Shield of California If you paid out of pocket for a test that was sent to a laboratory, follow the steps below to file a reimbursement claim. We are expanding access to vaccines, educating communities, and meeting ongoing healthcare and social needs in communities across the country. The Blue Cross Blue Shield System is made up of 34 independent and locally operated companies. If your employer has asked you to submit receipts to your pharmacy benefit plan, please dont submit them here. SECTION 2 - PATIENT INFORMATION Reason for the test cI was exposed to someone with COVID-19. Call your doctor. If you think you may have the virus or have been exposed to someone who has it: Not all testing sites are the same. (To submit a single form for multiple members and/or receipts, use a mail-in form instead. Chico, CA 95927-2540. 1996-Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue . Once we process your claim, the contract holder will receive a reimbursement check by mail. New User? (For example, you can buy 4 boxes that include 2 over-the-counter COVID-19 tests.). You can find a list of community-based testing sites here. What you need to know about the disease and our coverage commitment. This new site may be offered by a vendor or an independent third party. You may have to pay out of pocket at the time of purchase, but keep your receipt to submit a claim online. If you have any questions, call the phone number on the back of your subscriber ID card, also known as enrollee ID, or contact us and we'll help. If you paid for a COVID-19 test and think you might qualify for reimbursement, read the COVID-19 Testing Member Reimbursement Form (PDF) to find out more. cRequired for employment purposes. We use cookies on this website to give you the best experience and measure website usage. P/* ldF76Y*\v|*-9?S % If you are concerned mail has been suspended to the address previously provided, please call 1- 888-999-9862 and choose Option 2 for Pharmacy Programs. endstream endobj 467 0 obj <>/ProcSet[/PDF]>>>>stream Mail-in claims All OTC at-home tests ordered by a healthcare provider are covered. Waiving all prior authorization requirements for COVID-19 testing and related covered services. Call us at the Customer Service number on your BCBSTX member ID card. // ]]>, // >>/EncryptMetadata false/Filter/Standard/Length 128/O(a;uY[7y\\ Y)/P -1036/R 4/StmF/StdCF/StrF/StdCF/U(6Tn= )/V 4>> endobj 456 0 obj <>>> endobj 457 0 obj <> endobj 458 0 obj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageC]/Properties<>/XObject<>>>/Rotate 0/StructParents 10/Tabs/W/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>> endobj 459 0 obj <>/ProcSet[/PDF]>>>>stream If you do not have an itemized receipt, you must send us the barcode (UPC code) from your test(s) packaging. Blue Cross Blue Shield of Michigan PPO: 1-800-762-2382 Blue Care Network HMO: 1-800-482-5982 Medicare Plus Blue PPO: 1-888-803-4960 BCN Advantage HMO and HMO-POS: 1-800-431-1059 Or, learn more about all the mental health options available to you. Paper Claim Form. To receive reimbursement for over-the-counter/at-home tests with a receipt dated May 11, 2023 or prior, members with Independence Blue Cross prescription drug coverage should submit documentation through ibx.com. Register Now. To file a claim for those out-of-network services, youll need to use the claim form from the state where you were treated. Costco, Wal-Mart, Amazon), please attach itemized register receipts to the back of this form. Starting February 1, 2022, Medi-Cal members should obtain OTC at-home tests through pharmacies enrolled as Medi-Cal providers. By continuing to use this website, you consent to these cookies. Each test within a package is counted individually. If a test is sold in a package of two, that is considered two tests, and you'll be reimbursed $24. 2023 Blue Cross Blue Shield Association. One option is Adobe Reader which has a built-in screen reader. This currently does not apply to Medicare Advantage members. qGm1UCk3Ht}uh>.ky!R'@ E To pay no out-of-pocket costs, order your tests online through cvs.com or the CVS Pharmacy mobile app for store pickup1. To access your member services, please visit your BCBS company. If you have Medicare, you can go to www.empireblue.com/medicare for information about your plan. Everyone qualifies. qO;,lH Even if you have medical, vision, dental or prescription drug coverage through Blue Cross Blue Shield of Michigan or Blue Care Network, there may be occasions when you have to pay for services yourself. If you paid for a COVID-19 test and think you might qualify for reimbursement, read the COVID-19 Testing Member Reimbursement Form (PDF) to find out more. Tests that can be purchased at a retail location or online but are then sent to a lab for processing are not covered unless accompanied by a doctor's order (except for individuals covered by plans based in the District of Columbia). Updates to your COVID-19 coverage. If you purchased an OTC at-home test at the direction of your health care provider, please use this form: If you purchased an OTC at-home test for any other reason, please use this form: Send a copy of all your receipt(s) with the form. The Blue Cross Blue Shield Association is an association of independent, locally operated Blue Cross and Blue Shield companies. [CDATA[ Register Now. We are expanding access to vaccines, educating communities, and meeting ongoing healthcare and social needs in communities across the country. Reimbursement will be in the form of a paper check in U.S. currency and mailed to the address provided on your Retail Prescription Drug Overseas Claim Form. Once you reach the limit of eight tests per member per calendar month, we will not reimburse claims for additional tests. Find out if the testing site is charging a separate/additional fee to give you the test, and exercise caution if visiting a non-State regulated or out-of-network pop-up testing site which may not have the same standards or billing practices as an in-network provider with your health plan. 2023 copyright Anthem Insurance Companies, Inc. Stay informed by checking these resources for up-to-date information about COVID-19, especially if youre thinking about traveling. To be eligible for reimbursement, the purchased over-the-counter at-home COVID-19 tests: Members must complete a claim form to be reimbursed for over-the-counter COVID-19 testing. Just choose the form based on your group or plan and the service. Additional details about at-home COVID-19 testing can be found on the Blue Cross Blue Shield website. To live free of worry, free of fear, because you have the strength of Blue Cross Blue Shield companies behind you. Sources: California Physicians' Service DBA Blue Shield of California 1999-2023. You can also include multiple receipts with one form. Insights, information and powerful stories on how Blue Cross Blue Shield companies are leading the way to better healthcare and health for America. All 35 Blue Cross and Blue Shield companies are fighting against COVID-19, investing more than $12.8 billion in the nations recovery. Member Discounts Take advantage of member-only discounts on health-related products and services. Log in to blueshieldca.com (Engagement Point users at, Enter that information as indicated. 2Some pharmacies may not be able to process claims for OTC tests at the pharmacy counter. To submit a claim online, log in to, or register forMy Account, click My Documents, then Forms and select Over-the-Counter COVID-19 Test Online Claim to get started. endstream endobj 464 0 obj <>/ProcSet[/PDF]>>>>stream The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies. As part of our mission to improve and protect the healthcare system, particularly under the threat of the Coronavirus/COVID-19, the Blue Cross Blue Shield Association is focused on protecting members from fraudsters who seek to take advantage of the fear and confusion many feel surrounding the coronavirus/COVID-19 during these uncertain times. All Rights Reserved. CareFirst of Maryland, Inc. CareFirst Community Partners, Inc. and The Dental Network, Inc. underwrite products in Maryland only. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. OTC tests, also known as self-tests, detect if you are currently infected with COVID-19. Li@ c;8tH$0Neh,````1A88Co&) W e#f`lF|kQN2qC,`j` ` ;v this.go=function(){if(this.check()){var a=document.createElement("script");a.type="text/javascript";a.src=g;document.body&&document.body.appendChild(a)}}; All rights reserved. follow the latest CDC guidance for isolation. this.set=function(a,c){var b="",b=new Date;b.setTime(b.getTime()+6048E5);b="; expires="+b.toGMTString();document.cookie=a+"="+c+b+"; path=/; "}; If this happens, you can pay for the test and then submit a claim for reimbursement. How Your Benefits Work COVID-19 vaccination coverage after the Public Health Emergency Coverage for COVID-19 testing COVID-19 treatment If you have Medicaid, you can go to https://mss.empireblue.com/ny/home.html for information about your plan. at-home COVID-19 Test Reimbursement Claim form found here. Required documentation for this medical claim includes: The attestation included in our claims process ensures our members comply with the spirit of this policyto ensure tests are accessible and affordable for those who need them. Also, note that all American households can order free COVID-19 tests from the federal government. BCBS recognizes doctors and hospitals for their expertise and exceptional quality in delivering care. All information below is required. For help with these documents, please call 1-800-975-6314. The Biden administration announced that it intends to end the COVID-19 national and public health emergency (PHE) declarations on May 11, 2023. From January 15, 2022 until the end of the Coronavirus Public Health Emergency, each individual on your plan can get up to eight over-the-counter tests each month. (function(){var g=function(e,h,f,g){ If you purchase at-home tests without an order from your healthcare provider, you can be reimbursed for up to eight individual tests per member, per month. The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies. Important Legal and Privacy Information|Important Information About Medicare Plans|Privacy Practices You must submit a separate claim form for each covered family member. window.CE_READY = function () { CE2.listen(window, 'click', function(evt) { In Virginia, CareFirst BlueCross BlueShield, CareFirst MedPlus, and CareFirst Diversified Benefits are the business names of First Care, Inc. of Maryland (used in VA by: First Care, Inc.). Heres everything you need to know about it. Call the National Information Center at 1-800-411-BLUE (2583) weekdays from 8 a.m. to 8 p.m. Eastern time. Worlds Most Ethical Companies and Ethisphere names and marks are registered trademarks of Ethisphere LLC. W006259 COVID-19 Testing Member Reimbursement Form - Non-Medicare Advantage Please use this form to request reimbursement for COVID-19 tests you have paid for out of your own pocket. You may need to show your red, white and blue Medicare identification card. You are now leaving the blueshieldca.com website, Do NOT use this page for test reimbursement. endstream endobj 462 0 obj <>/ProcSet[/PDF]>>>>stream hbbd```b``)n`"EV`U`*8*I2&?tq&e@$E&">I0DjE0!c`) $L*H-`l)`l3Oz's&30t%S! [& California Physicians Service DBA Blue Shield of California is an independent member of the Blue Shield Association. As the COVID-19 pandemic continues, testing is an important way to limit the spread of the disease. We provide health insurance in Michigan. What Impacts the Cost of Health Insurance? For example, one box containing two tests counts as two tests. Purchase up to 8 tests per family member in a 30-day period. testing after you received an initial COVID-19 test. Your health plan covers FDA-authorized COVID-19diagnostic testingat no cost until the end of the public health emergency on May 11, 2023. Visitcovidtests.gov, and click the blue "Order Free At-Home Tests" button. At-home diagnostic tests can be purchased over the counter, online, at a local pharmacy, or from a big-box store. How can I resolve a problem with my PPO or HMO claim? Provide an itemized receipt that clearly shows that your purchase was for a COVID-19 test. If you have Medicare Part B (includes Medicare Advantage), you can get up to 8 free over-the-counter tests each month, until the end of the COVID-19 public health emergency on May 11, 2023. Please enter the NDC or UPC number from the cash register receipt or test package. window.CE_READY = function () { CE2.listen(window, 'click', function(evt) { if (evt.target.id=== 'QSIFeedbackButton-btn' || (evt.target.matches && evt.target.matches('#QSIFeedbackButton-btn *')) ) { CE2.set(1, 'feedback'); } }); } (To submit a single form for multiple members and/or receipts, use a mail-in form instead.
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